HomeMy WebLinkAbout72314D - Point;(CAMA / )< DREDGE & FILL 'rpt 1' op ►V%Jr_n No 72314
GENERAL PERMIT izl� / 19 A B c D
Previous permit #
f)(New XModification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to ISA NCAC 0-714. 1100
T r,-� ❑ Rules attached.
Applicant Name I F� r0w T 1—L- C
Address 1900
Vi"ACr_
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RP
City S IIAAi-L
State Aft
ZIP 2-8+70
Phone # (10 ) 4-43 - 081 4 E-Mail 4-heooin+0^4r
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Authorized Agent
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Affected
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AEC(s):
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o N/A/
❑ PWs:
ORW: yes / no PNA yes / no
Project Location: County 1!> Ru /U5 W f G 1G
Street Address/ State Road/ Lot #(s) i 8 0 9
Subdivision
City Swau,oTTE ZIP Z8470
Phone # ( ) River Basin LtIN'6 eR
Adj. Wtr. Body AN w man unkn
Closest Maj. Wtr. Body A 1 w W
Type of Project/ Activity
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Agent or Applicant Printed Mime
Signature "Please read compliance statement on back of permit"
$ 4.00 / 9 38
Application Fee(s) Check #
f yLER M C-
Permit Officer—'s- Printed Name
Signature
10I9 /;Zo l q 2/ 9 12020
Issuing D"ate -
-r,D Moo w-,i-O 12/7-0 1 xpiration Date
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
C ,
Name of Property Owner Requesting Permit:
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
\ � d 'V- o—c
av, �AcA� <�Ve
Agent 1
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: C--C..4- S'e C' (. -re�
at my property located at CUcIy , <<c tC
i��wr�SZ Z County. n
l furthermore certify that l am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer, and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
SignatuRb
Print or Type Na e
Title
LD/ M / 2(36
Date
This certification is valid through 1! �k / -3 1 / I o'), 0
U.S. postal Service
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Receipts for
Certified Mail
(Staple Here)
Carrie, 147i`f,'ke' A
Adjacent Property Own r
yo 3 C44-dyic4- flay
Mailing Address
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you that I, —77e. have applied for a CAMA Minor
Property Owner
Permit on my property at �� La u (, %�-� P in COUNTY
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form.. If
you have any questions or comments about my proposed project, please
contact me at ql 0-7J 7— Q 7 or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT LAMA Minor Permit Program, you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY, STATE, ZIP CODE
Sincere
Property er
P( >
?UU 11%%C
Mailing Address //LL
City, State, Zip Code
10/1=019
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Tracking Number: 70180680000070262054 Remove X
Your item was delivered at 12:23 pm on September 30, 2019 in Q
SHALLOTTE, NC 28470. v
OV Delivered
September 30, 2019 at 12:23 pm
Delivered
SHALLOTTE, NC 28470
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a-2
Date
,�L
Adjacent Propel Owner
d"-7 o Gid C4—, lel
Mailing Address -// x
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you that I,
Property Owner
C
Receipts for
Certified Mail
(Staple Here)
have applied for a CAMA Minor
Permit on my property at ! 7 V G 64 //. jf P'�- r � , in COUNTY
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 910.7s�, ^ 2 7?
Applicant's Telephone
,or by mail at the address listed below. If you wish to
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program, you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY, STATE, ZIP CODE
Sincerely,
Property Owrfer
Mailing Address
-5r'b 1? /6, 02o
City, State, Zip Code
ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to .��` (64 V- e L,/ 's
(Name of Property Owner)
property located at �i�� 6 �- (./ - `-,-
Address, Lot, Block, Road, etc.)
on in �� H-^c L,11 C, , N.C.
(Waterbody) (Town and/or County)
He has described to me as shown in the attached application and project drawing(s), the development
he is proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
(2C J_,
Signatur
Print or Type Name
XV'( 3'1 2.5 � 2-
Telephone Number
/-/ s s
Dates—
2
Date Received
Date Deuosited
Check From Name
Name of Permit Nokler
Vendor
Check Number
Check
amount
Permit Numbe comments
Receipt or Relund?tealbcated
Columnl
Column2 Column3
Column/
Column5
ColumnQ
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Column8
Column8
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